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1165 E Cherry St Troy MO 63379-1520 | |
(636) 528-7722 | |
(636) 528-7744 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 1165 E Cherry St, Troy, Missouri |
Authorized Official Name and Position | Patrick G Bira (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6365283326 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1165 E Cherry St Troy MO 63379-1520 Ph: (636) 528-7722 | 1165 E Cherry St Troy MO 63379-1520 Ph: (636) 528-7722 |
NPI Number | 1902820012 |
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Provider Enumeration Date | 07/26/2006 |
Last Update Date | 12/18/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902820012 | NPI | - | NPPES |
242201705 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Lewis Meyerson, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Sarah Ann Blvd, Troy, MO 63379 Phone: 636-528-5281 Fax: 636-462-2637 | |